人下颌第一磨牙全瓷修复体预备量与粘接面积的初步研究

›› 2017, Vol. 37 ›› Issue (10): 875-879.

人下颌第一磨牙全瓷修复体预备量与粘接面积的初步研究

孙冠阳¹,王嘉¹,韩宁宁²,周峰³,巴睿恺¹,吴国锋²

1. 第四军医大学口腔医院
2. 南京市口腔医院
3. 南京大学附属口腔医院

收稿日期:2017-03-27 修回日期:2017-05-10 出版日期:2017-10-28 发布日期:2017-10-13
通讯作者: 吴国锋 E-mail:wgffmmu@sina.com
基金资助:
全瓷修复体牙体预备与恒牙三维结构关系的初步研究

Preliminary study on the preparation and bonding area of all ceramic restorations of human mandibular first molar

Received:2017-03-27 Revised:2017-05-10 Online:2017-10-28 Published:2017-10-13

摘要/Abstract

摘要： 目的　量化和比较下颌第一磨牙不同瓷修复体预备量（磨切的牙体组织占牙冠硬组织的体积百分比）、粘接面积。方法　收集10颗人离体下颌第一磨牙，采用Micro CT对其进行扫描和重建，通过3D打印的方法批量复制为4组(A、B、C、D)，每组10个，按照牙体预备标准对3组样本分别进行全瓷冠(A1-A10)、邻全瓷嵌体(B1-B10)和多面全瓷嵌体（MOD）(C1-C10)预备，D组（D1-D10）为空白对照组；最后采用逆向工程软件Mimics 和Geomagic Studio对修复体预备量、粘接面积进行测量分析。结果　下颌第一磨牙全瓷冠、邻全瓷嵌体和MOD全瓷嵌体的预备量依次为36.21%、5.75%和11.93%；粘接面积测量结果为：全瓷冠169.96 mm2、邻全瓷嵌体40.27 mm2、MOD全瓷嵌体81.94 mm2,不同全瓷修复体的预备量、粘接面积的差异均有统计学意义；邻全瓷嵌体和MOD全瓷嵌体牙釉质粘接面积分别为26.55 mm2、55.13 mm2，牙本质粘接面积分别为12.92 mm2、23.97 mm2，牙釉质粘接面积＞牙本质。结论　下颌第一磨牙全瓷修复体预备量、粘接面积的大小与修复体类型有关；下颌第一磨牙全瓷嵌体粘接边缘线牙体组织为牙釉质，提示临床应采用牙釉质粘接的方式进行修复体粘结。

关键词: 下颌第一磨牙, 全瓷冠, 全瓷嵌体, 预备量, 粘接面积

Abstract: Objective To quantify and compare the volume of tooth preparation(the volume percentage of the tooth tissue prepared to the hard tissue of crown) and bonding area of mandibular first molar. Methods Ten extracted mandibular first molars were collected. The teeth were scanned by Micro CT, then reconstructed into 3D model and copied by 3D printing method into four groups（A、B、C、D）each with ten teeth，and the teeth were prepared with the following designs: ceramic crown（A1-A10），medial-occlusal cavity ceramic inlay（B1-B10）, and MOD ceramic inlay（C1-C10），D（D1-D10）was blank control group. Finally，the reverse engineering software Mimics and Geomagic Studio were applied to analyze the volume of tooth preparation and bonding area. Results Different designs of mandibular first molar were statistically significant in the volume of tooth preparation and the adhesive area. The volume of tooth preparation: ceramic crown (36.21%), medial-occlusal cavity ceramic inlay(5.75%), MOD ceramic inlay(11.93%); the bonding area: ceramic crown (169.96 mm2), medial-occlusal cavity ceramic inlay(40.27 mm2), MOD ceramic inlay(81.94 mm2); the enamel bonding area: medial-occlusal cavity ceramic inlay(26.55 mm2), MOD ceramic inlay(55.13 mm2), the dentin bonding area: medial-occlusal cavity ceramic inlay(12.92 mm2), MOD ceramic inlay(23.97 mm2), the enamel bonding area was more than dentin. Conclusions The volume of tooth preparation and bonding area are related to the type of dentures. The exposure of enamel identified at the margins of the ceramic inlays preparation suggests that enamel adhesions should be used.

Key words: mandibular first molar, all-ceramic crown, ceramic Inlay, volume of tooth preparation, bonding area.

中图分类号:

R783.3

孙冠阳王嘉韩宁宁周峰巴睿恺吴国锋. 人下颌第一磨牙全瓷修复体预备量与粘接面积的初步研究[J]. , 2017, 37(10): 875-879.

参考文献

[1] 骆小平. 不同瓷修复体基牙预备特点[J]. 中国实用口腔科杂志, 2009, 2(1):21-25.
[2] 祁京华. 全瓷冠常见并发症的预防及临床处理[J]. 医学信息旬刊, 2010, 23(10):3919-3920.
[3] 马金兰, 石四箴, 药师寺人,等. Micro-CT扫描下颌乳中切牙釉质厚度的研究[J]. 临床口腔医学杂志, 2009, 25(9):521-523.
[4] 顾永春, 朱琦, 周培刚,等. 利用显微CT及三维重建软件Mimics测量牙根表面积[J]. 牙体牙髓牙周病学杂志, 2013, 23(12):757-762.
[5]　王书明, 张大鹏, 郑亚琪,等. 人下颌第一磨牙釉质帽与牙本质核三维形态的初步研究[J]. 牙体牙髓牙周病学杂志, 2014(12):705-708.
[6]　聂杰, 王晓燕, 高学军. 不同牙体修复材料与Ⅱ类洞龈壁适合性的显微CT观察[J]. 北京大学学报医学版, 2015, 47(2):317-320.
[7]赵铱民主编.口腔修复学.第7版. 北京：人民卫生出版社，2012：121-123，--
[8] Edelhoff D, Sorensen J A. Tooth structure removal associated with various preparation designs for anterior teeth [J]. Journal of Prosthetic Dentistry, 2002, 87(5):241-249.
[9] 沈燕青, 胡赛, 孔卓玲,等. 中切牙金属烤瓷冠牙体预备的探索性实验[C]// 全国口腔医学教育学术年会. 2015.
[10] Davis G R, Tayeb R A, Seymour K G, et al. Quantification of residual dentine thickness following crown preparation[J]. Journal of Dentistry, 2012, 40(7):571-576.
[11] 刘思璇, 吕培军, 王勇,等. 全冠预备体评价指标的计算机辅助量化方法[J]. 北京口腔医学, 2011, 19(4):190-193.
[12] Ma J L, Shi S Z, Ide Y, et al. Volume measurement of crowns in mandibular primary central incisors by micro-computed tomography[J]. Acta Odontologica Scandinavica, 2013, 71(5):1032-1037.
[13] 杨新海, 曾祥龙. 中国人正常牙合牙齿位置和形态[J]. 北京大学学报医学版, 1998, 30(6):528-531.
[14] 杨杨, 季娟娟, 王祥云,等. 不同牙体预备量的动物实验研究[J]. 临床口腔医学杂志, 2010, 26(11):652-654.
[15] Camps J, Déjou J, Rémusat M, et al. Factors influencing pulpal response to cavity restorations.[J]. Dental Materials, 2000, 16(6):432-440.
[16] 热娜古孜?阿不都米吉提, 迪丽努尔?阿吉. 影响固定修复体固位力的因素[J]. 口腔医学, 2010, 30(5):309-311.
[17] Nattress B R, Youngson C C, Patterson C J, et al. An in vitro assessment of tooth preparation for porcelain veneer restorations[J]. Journal of Dentistry, 1995, 23(3):165-70.
[18] 孙亚洲, 陈亚明. 两种不同固化处理的复合树脂黏接微拉伸强度测试研究[J]. 口腔医学, 2005, 25(2):98-99.
[19] 刘玉华, 尹亚梅. 嵌体修复体的微漏分析[J]. 口腔颌面修复学杂志, 2003, 4(2):116-118.
[20] Cas R A F, Wright H M N, Folkes C B, et al. Comparison of microtensile bond strength to enamel and dentin of human, bovine, and porcine teeth[J]. Journal of Adhesive Dentistry, 2004, 6(2):117-121.